6. URTI Flashcards
What are the causes of tonsillitis?
Viral – adenovirus, rhinovirus, influenza, RSV
Bacterial – strep pyogenes (group A)
Outline the pathophysiology of tonsillitis
Inflammatory infection of the tonsils caused by invasion of the mucous membrane by microorganisms.
Subtype of pharyngitis
What are the signs and symptoms of tonsillitis?
Red, swollen tonsils
White or yellow coating or patches on the tonsils
Sore throat
Difficult or painful swallowing
Fever
Lymphadenopathy
A scratchy, muffled or throaty voice
Bad breath
Stomach-ache, particularly in younger children
Stiff neck
Headache
How should tonsillitis be investigated?
Throat exam
Throat swab (if bacterial suspected)
Fever/pain score
How is tonsillitis best managed?
Rest, hydration, saltwater gargle, lozenges, avoid irritants, ibuprofen/paracetamol
Abx – amoxicillin
Surgery – tonsillectomy
Outline the possible complications of tonsillitis
Difficulty breathing
Obstructive sleep apnoea
Tonsillar cellulitis
Peritonsillar abscess
Outline the details of a common cold
Aetiology = viral – rhinovirus
Pathophysiology = viral infection of the URT, transmitted via airborne droplets.
S+S = cough, runny nose, sneezing, nasal congestion, sore throat, muscle ache, fatigue, headache, loss of appetite
Investigations = clinical diagnosis, Fever/pain score
Management = ibuprofen, rest, hydration, salt-water gargle
Complications = otitis media, sinusitis
Outline the aetiology and pathophysiology of otitis media
Acute middle ear infection. More common in infants, children than in adults (eustachian tube shorter and more horizontal = easier passage for infection from nasopharynx, can block easily, increased risk of infection)
Bacterial = H. influenzae S. pneumoniae, S. pyogenes (All common upper resp track MO)
Viral = Respiratory Syncitial Virus, Rhinovirus
What are the signs and symptoms of acute otitis media?
Otalgia (infants pull/tug at the ear)
Fever
Red +/- bulging TM and loss of normal landmarks
Malaise
Erythematous TM
TM perforation with discharge
Conductive hearing loss
Cervical lymphadenopathy
How should acute otitis media be investigated?
Function of facial nerve
LN exam
Throat and oral cavity examination
FBC, CRP
Discharge = C+S
What is the best management for acute otitis media?
Majority resolve within 1-3 days - watch and wait
Oral fluids, analgesia
Oral Abx (commonly amoxicillin) = Systemically unwell children, congenital heart disease, immunosuppression, >4 days, discharge
What are the possible complications of acute otitis media?
TM perforation
Facial N involvement
Mastoiditis
Intracranial complications
Meningitis
Sigmoid sinus thrombosis
Brain abscess
